血管紧张素Ⅱ受体拮抗剂对糖尿病肾病患者微量白蛋白尿的作用不受血压影响  

The Effect of Losartan on Microalbuminuria in the Treatment of Early Stage of Diabetic Nephropathy Independent of Blood Pressure

作　　者：马红[1] 杨香玖[1] 黄延玲[1] 黄群[1] 张岩[1] 陈小敏[1] 沈兴平[1] 

机构地区：[1]厦门大学附属中山医院内分泌科(福建医科大学教学医院),福建厦门361004

出　　处：《中华高血压杂志》2006年第12期997-999,共3页Chinese Journal of Hypertension

摘　　要：目的研究血管紧张素Ⅱ受体拮抗剂（ARB）氯沙坦对2型糖尿病、糖尿病肾病患者微量白蛋白尿的治疗效果。方法血压正常的2型糖尿病患者43例，其尿白蛋白排泄率（UAER）在20～200μg／min之间，其血糖控制在可接受水平[空腹血糖（FBG）≤7mmol／L，餐后2h血糖（P2hBG）≤10mmol／L]。随机分为治疗组23例，对照组20例，对照组在控制血糖基础上加用安慰剂，治疗组加用ARB氯沙坦50mg／d。两组患者在治疗前和治疗12周后复查FBG、P2hBG、糖化血红蛋白（HbAlc）和UAER。结果治疗12周后，治疗组UAER为（76±11）μg／min，与治疗前（119±14）μg／min相比明显下降（P〈0.05），与对照组（125±13）μg／min比较，差异有显著性（P〈0.05）。结论对血压正常的2型糖尿病早期糖尿病肾病患者，ARB氯沙坦在对血压无影响的情况下具有独特的降低尿微量白蛋白水平，延缓糖尿病肾病进展的作用。Objective To investigate whether the effect of angiotensin Ⅱ receptor antagonist losartan on mieroalbuminuria in patients of diabetic nephropathy independent of blood pressure . Methods Fouty-three patients with early stage diabetic nephropathy were randomly divided into two groups, 23 in treatment group（ losartan 50 mg/d） and 20 in control group. Blood pressure in all patients were in normal range. Plasma glucoses were controlled to the level of fasting blood glucose （FBG） ≤7 mmol/L, and postprandial 2 h blood glucose （P2hBG） 410 mmol/L. The urinary albumin excretion rate （UAER） of all patients was between 20 to 200μg/min. The control group patients were administered with placebo. Fast blood glucose （ FBG ）, post 2 h blood sugar （ P2hBG）, HbAle and urine albumin excretion rate （UAER） were examined before and 12 weeks after the treatment. Results After 12 weeks, the mean mieroalbuminuria level in treatment group declined signifieantly from 119±14 μg/min to 76±11 μg/min （P〈0. 05）, compared to that of control group 125±13 μg/min （P 〈0. 05）. However, no changes in BP was found before and after treatment. Conclusion Angiotensin Ⅱ receptor antagonist decrease mieroalbuminuria and postpone the deterioration of diabetic nephropathy in type2 diabetes patients independent of blood pressure.

关 键 词：糖尿病肾病 微量白蛋白尿 血管紧张素Ⅱ受体拮抗剂 

分 类 号：R587.2[医药卫生—内分泌]